Registration Form If you are ready to book your dog in with us, please complete and submit the following form: Dog's Name Name/s of other dog/s from same household also included in booking: Owners Name First Name Last Name Address Email * Main Phone * (###) ### #### What services are you booking? Day Care Overnight Drop off Date MM DD YYYY Drop Off Time Hour Minute Second AM PM Collection Date MM DD YYYY Collection Time Hour Minute Second AM PM Additional details (E.g. repeat bookings for set day, adhoc) Dog's date of birth and approximate weight Dog's gender * Is your dog neutered? * Yes No Breed description Microchip number Does your dog have any fears or phobias? Is your dog safe and happy to be around children? Please give details: Has your dog ever shown aggression to another dog or person? please give details: Dog's usual feeding routing, include amounts and time of the day: NB. You will need to provide your dog's food for the duration of their stay, plus some spare; if there is insufficient food they will be given a hypoallergenic food that may incur an additional charge. Does your dog have any medical issues, or require any treatments, please provide details: Does your dog have any allergies? Date of last flea/ worm treatment NB. Dogs must be up to date with treatments Do you consent to additional flea/ worm treatment being provided if found to be necssary? * Date of previous vaccinations: NB. You must show evidence of vaccinations, e.g. record from vet, in order to secure the booking Dog's registered vet; name, address, telephone number: If your dog needs urgent medical attention, do you give consent for me to take them to my local vet; Vale Vets in Pill and Portishead (This will include transportation in my car) If your dog is insured, please provide the company name and policy number: Name, contact number and address of emergency contact person: * Do they know that they are your emergency contact person? * Yes No Your dog's usual exercise routine; e.g. duration of walks, times of day E.g. 2x30 minute walks or 1x 60 minutes Fetching ball, playing with tug rope, treats in a Kong etc. Does your dog have any restriction on exercise? If so provide details: Do you consent to your dog /s being exercised using the outdoor area alongside other dogs? * Yes No Do you consent to your dog/s being walked outside of the home environment? * Yes No If you use anything other than a collar and lead to walk your dog, please advise here: Do you you consent to your dog/s boarding with other dogs (although eating and sleeping at night in separate rooms if needed) if they have previously been familiarised and deemed compatible for mixed boarding? * Yes No Do you consent to your dog/s being walked with other dogs? Yes No Do you consent to your dog being left for a short time, while another dog is being walked for instance? * Yes No Does your dog chew household items? Do you consent to me grooming your dog if needed, including brushing/ shampooing if they get very dirty? * Off lead permission? * I hereby give Claire's Happy Dog Day care and Boarding permission to take my dog off lead on walks in a safe area away from traffic and livestock. I certify that to my understanding, my dog is trustworthy off lead and has a good recall. I realise that there are certain risks involved with off lead walks and that I will not hold Claire's Happy Dog Day Care and Boarding responsible in any way should any harm come to my dog; Signed: Yes No Any comments related to allowing your dog off lead: Please describe you dog's usual/ regularly used commands: E.g. 'sit, lie down, wait, off, heel, come to me, toilet....' Any additional information: I hereby agree to Claire's Happy Dog Day Care and Boarding terms and conditions: * Signature and date Thank you!
